Help staff transition when decentralizing pharmacy
Keep communication lines open
When health care institutions decide to decentralize their pharmacies or increase their pharmacists' involvement in patient care, not everyone will be happy with the change.
Some pharmacists are very content with continuing to be involved in the distribution of medications and are not eager to provide bedside services. So it's up to hospital pharmacy leaders to help staff make the necessary changes and transition into new roles.
"I think some members of our staff were happy with what the practice was," says Jennifer E. Tryon, PharmD, MS, an assistant director of pharmacy at Oregon Health & Science University hospital and clinic in Portland, OR.
The Oregon Health & Science University hospital is moving toward a decentralized pharmacy model in which each pharmacist has clinical care duties. So Tryon has helped them to understand why the change is needed and how they successfully can make a transition to a decentralized pharmacy model.
Pharmacists will continue to work in the central pharmacy, but only as part of a rotation that also will include patient care areas, Tryon says.
During the transition, managers asked pharmacists where they'd like to work. For instance, some have specialized in pediatrics and might prefer their clinical duties to be in the pediatric unit, she explains.
"We've had several pharmacists say they're interested in being on a central pharmacy team or being in central pharmacy," she says. "So they're not really interested in going into clinical work."
However, that's not one of the options available to the staff.
The organization's goals and vision are to improve access for patients and to integrate pharmacists in the health care team so they can influence and improve patient outcomes in a proactive manner, Tryon says.
"The part I play and other managers play is sitting down and talking about why this change is happening and what our vision is, and we share that background with staff," Tryon says. "We talk about our timeline and what we want to do to help them with the transition."
Some of the longtime central pharmacy staff who enjoyed the status quo offered these reasons why they didn't want to transition to clinical care:
- "I'm happy in my current role."
- "I never trained as a clinical pharmacist and didn't do a residency."
- "My expertise is in the IV room and not necessarily up on a unit."
"We listened to their concerns and worked through them, trying to help them understand what clinical practice is," Tryon says.
For instance, managers could already point to ways in which older pharmacists have seen major changes in their workflow, including the transition from using a lot of math and compounding skills to working with technology and products that arrive in unit doses, she says.
As communication about the transition continued, the staff's anxiety began to dissipate, she notes.
"When you're centralized, there's a little more clarity in what your day is going to look like," Tryon says. "When you're decentralized, then maybe a code will happen or someone will throw you an unusual question on your rounds, or an unusual clinical trial comes up, and they ask you about it."
So the key for managers is to keep in mind that any change involves employees' feelings and fears about what might occur.
"The transition involves not only process, but people, and making sure they have opportunities to discuss their concerns," Tryon says.
From a management perspective, it's important to have each employee meet with a manager to discuss questions and concerns, she adds.
Also, managers should continually bring the message back to the organization's vision so people understand why the change is occurring.
"We put up a big white message board in our hallway, so if people have a comment and aren't comfortable talking to us, they can put that comment on the message board," Tryon explains. "Then we reply back on the board, and we meet as a group to review the comments."
Managers type up their response to staff concerns and post it on the boards, she adds.
"If we mistook their question, then they can rephrase it and put it back on the board or talk with us about it," Tryon says.
Managers should communicate with staff in a variety of ways, because it might take different methods to attract everyone, she notes.
"E-mail is our primary mode of communication," Tryon says. "The staff decided on using e-mail."
But they communicate in other ways, as well, including using change diagrams, speaking individually with staff, and holding frequent leadership team meetings, Tryon says.
Tryon often discusses change in abstract terms with the staff.
"When we're younger we change on an ongoing basis, and what we need to realize as we get older and into our professions is that change continues to happen," Tryon explains. "We can't take for granted when we're done with school and our residency that change won't happen anymore, especially in this field with new medications and new entities all the time."
Tryon also appeals to pharmacists' sense of adventure: "I can't imagine anyone deciding to become a pharmacist to have every day stay the same or have a predictable regimen," she says. "It's expected when you're a pharmacist that every day is a little different and always a challenge and never the status quo."
The preparation for the decentralized pharmacy change apparently has paid off for the organization.
"We're mid-transition right now, and, so far, we have not lost anybody," Tryon says.
When health care institutions decide to decentralize their pharmacies or increase their pharmacists' involvement in patient care, not everyone will be happy with the change.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content